Getting Heterosexual Black Men Involved in HIV Prevention, Part 1

Read any report on HIV in black America, attend any HIV conference or look up at an HIV prevention billboard and it's clear who is most impacted by this epidemic in the U.S.: black men who have sex with men (MSM) and black heterosexual women. Perhaps that heavy focus, along with homophobia in the black community, is what led to the belief in the down-low phenomenon, according to which duplicitous and sinister bisexual men are sleeping with men and also having unprotected sex with women.

Kellee Terrell, News Editor for TheBody.com

And while so many in the African-American community buy into this myth, science demonstrates that that just isn't so. The down low is not fueling the HIV epidemic among black women. So, if it's not about men on the down low and the main source of HIV transmission among black women is heterosexual contact, at what point are we going to address the elephant in the room?

Heterosexual men do have HIV, and they are falling through the cracks.

In order to fully address this epidemic head on, we have to include heterosexual African-American men. But how do we go about doing this given the stigma and homophobia in the black community? What work is being done now that is making an impact among this demographic? And where are the heterosexual men living with HIV who will speak out?

Kellee Terrell: Ingrid, what are some of the major barriers that you face when getting heterosexual black men to get tested for HIV, use condoms or even come forth with their stories of being positive?

Ingrid Floyd, Executive Director for Iris House

Larry Bryant, National Field Organizer for Housing Works

Ingrid Floyd: One difficulty that we face is that this conversation has traditionally been centered around men who sleep with men or gay men. And so a lot of heterosexual men tend to think that HIV doesn't affect them, that they are not impacted by HIV because of their heterosexual behaviors. They don't see themselves as being at risk.

I also think that, particularly in the black community, there is a taboo around condom use. There is the perception that someone who uses condoms is promiscuous, or you only use condoms if you're not trying to get pregnant. And so we have not made condom use a social norm in our communities.

So the fact that they don't see themselves at risk and the fact that condom use isn't a social norm make it even more difficult to get people to come in to get tested and learn more about HIV.

And definitely, because of the stigma around HIV, it makes it even more difficult for anyone who is living with HIV to come forward. It takes a little longer for us to get them to a point where they want to come in for supportive services, as well as to make sure that they're maintaining medical services.

Larry Bryant: I have to echo what Ingrid said about stigma, and the environment within the black community around homophobia, and just that acceptance of being able to talk about HIV and sexuality among men. Looking at how men and their sexuality have been historically represented in movies, such as Shaft and Mandingo, coupled with other stereotypes, such as the strong, silent black man, we have not yet been comfortable communicating our sexuality, or issues related to sex and identity. And nowadays, we repeatedly see images in videos and music that convey the macho, kind of non-emotional, non-communicative man -- you know, monosyllabic in communication.

But I think that economic disparities and educational disparities among black men also play a factor. For many, sexual health is not even a priority among the things that they need to deal with. It's about getting a job, getting an education, and making ends meet; it's about survival. HIV and STDs [sexually transmitted diseases] are just not on their radar.

A lot of young men, especially in the inner city, don't even expect to live into advanced stages of adulthood. It's almost a kamikaze attitude with some young black men to not anticipate having a long life.

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